Database Development
1. Introduction: Importance of Scalable Healthcare Applications
The healthcare industry is going through the largest transformation we have ever seen and with this change comes a large number of digital health technologies. Telehealth, e-Prescriptions and remote patient monitoring are some examples of how digital health has changed the way we provide care. However, with this new way of delivering care also comes complexity and scalability is a significant factor in successfully scaling your healthcare applications.
In India, the need for scalable healthcare applications is not just nice to have, but it is essential. All healthcare applications will have 3 major pieces of growth: user growth, features growth and data growth. By ensuring that your application can scale with these 3 major growth factors without performance degradation, you will be able to provide a sustainable platform that provides a great experience for both patients and providers. This article covers the things that all Healthcare Providers need to understand in order to create scalable healthcare applications that are ready for the future.
2. The Meaning of Scalability in Healthcare Application Development
Scalability means being able to increase the size of an application as well as being able to support increased demand via:
- Your Application needs to support a larger population of users (the total number of Patients, Providers, and Administrators).
- Your Application needs to support an increased number of transactions processed daily (i.e. the volume of Health Data to be Processed).
- Your Application needs to be able to interconnect with Medical Devices and integrate with other External Systems.
- Your Application needs to be able to add New Features without causing any disruption to existing Functions.
Within the multiple language, multiple geographic regions, and multi-ethnic cultures of the Indian Healthcare System, the scalability of a Healthcare Application can truly mean the difference between Providing Consistent Care and Having System Failures during Peak Usage.
3. Core Pillars of Scalable Healthcare Apps
a) Robust Backend Architecture
The foundational foundation for building scalable healthcare applications is a scalable backend architecture. A cloud architecture (e.g., AWS, Azure or Google Cloud) provides the following features:
- Automatic scaling up according to usage that would be expected during busy times.
- Reliability through redundancy.
- Efficient use of resources.
Through the use of microservices, as opposed to a monolithic design, it is possible to allow different system elements to scale independently of one another.
b) Data Security and Compliance
Healthcare applications require access to very sensitive data. As such, it is crucial to ensure compliance with India’s data protection legislation, so that PII (Personally Identifiable Information) and health information is kept confidential.
To provide the highest level of security in managing sensitive healthcare data, these are some recommended approaches to best practice security measures:
- End-to-end encryption of data (secured throughout transfer and storage)
- Implementing multi-factor authentication (MFA)
- Secure API access
- Regularly conducting assessments for security vulnerabilities
Also, if your application receives communications from outside of India or connects with other applications (such as integrating to receive instructions from a patient), ensure that you are in compliance with country or region-specific standards, such as HIPAA, GDPR or ISO 27001 for the United States, Europe or Canada, respectively.
c) Interoperability and Open Standards
In order to create scalable healthcare applications, it is essential to create connections between different systems (lab systems, electronic medical record systems, pharmacy systems, insurance systems); creating methods to make that happen requires open standards.
Utilizing open standards such as FHIR (Fast Health Interoperability Resources) and HL7 will facilitate the ease with which systems transfer information to one another.
4. Factors of Scalability and Usability in Healthcare Applications
a) Video Consultation and Telemedicine
Telemedicine adoption grew rapidly in India after the COVID-19 pandemic. Some critical elements for scaling telehealth technologies include:
- Using a reliable video software development kit (SDK) such as WebRTC
- Working under low bandwidth conditions
- Complying with privacy regulations and recording guidelines
b) Booking and Scheduling Appointments
The development of a dynamic scheduling engine allows both patients and providers to easily book appointments with each other, even at peak times. Some examples of dynamic scheduling features include:
- Alerts for waiting lists and cancellations
- Ability to synchronize calendars
- A dashboard showing when doctors are available
c) Patient Engagement Features
While websites and mobile apps are useful for basic tasks, they are much more powerful when used to engage users with new and exciting features. Some examples of patient engagement features include:
- Push notifications (e.g., reminders for medication, check-ups)
- In-app chat functionality
- Health education resources
- Ability for patients to provide feedback on their experience
Patient engagement drives loyalty to the app and encourages consistent usage.
5. New Technologies to Increase Scalability
a) Cloud & Edge Computing
Cloud computing provides elastic scalability by allowing resources to grow or decline based on usage. When combined with edge computing (where computation occurs closer to the user), we can reduce latency. This is especially important for rural areas.
b) AI and Machine Learning
AI can help increase:
- Predictive health analytics
- Recommendations for patients
- Automating administrative tasks in clinical settings
In addition to creating overall better user experiences, these technologies will reduce the amount of time required by clinical staff to process information.
c) Blockchain for Secure Data Sharing
Blockchain can help build and maintain:
- Tamper-proof health records
- Manage patient consent
- Single point of access for health records
This will be particularly useful for multi-provider networks that require trust and transparency.
6. Challenges in Developing Scalable Health Applications
a) Regulatory Environment
As the regulations in India continue to change and evolve, it is critical that you implement privacy-by-design in your application as well as remain up-to-date with the Digital Personal Data Protection Act.
b) Digital Divide and Infrastructure Limitations
Many areas in India have limited to no access to a reliable internet connection. It is critical that the functionality of your application is designed for:
- Limited data transmission
- Offline usage
- Caching of data
Having a usable application in areas of limited connectivity will help increase usage and adoption.
c) Cost Management
Just because scalability can lead to increased costs doesn’t mean you should implement your application without being financially responsible. By using cloud cost optimization techniques like:
- Auto-scaling groups
- Pay-as-you-go models
- Serverless computing
7. Test Scalability – A Critical Step You Cannot Ignore
Your Quality Assurance should include testing for Scalability:
- Load Testing – Simulating user loads at their peak levels
- Stress Testing – Testing for where the system may fail
- End-to-end Testing – Testing to verify all the components of your system work together
Performance Validation Tools like JMeter, LoadRunner and Gatling help you to test how well your app performs, before you launch.
8. India Examples of Real Life Use Cases
India’s health tech industry is rapidly growing with scalable apps providing accelerated healthcare delivery:
- Remote Teleconsultations
- Vaccine Scheduling
- Rural Health Care
- Chronic Disease Management
These examples show that scalable applications are not just for the future; they are currently changing the way we deliver healthcare.
9. Selecting A Development Partner
The right development vendor (technology provider) makes all the difference; one who understands:
- What it is like to deliver healthcare in India
- The legal and regulatory framework for delivering healthcare in India
- How can we leverage the latest technologies, such as AI, Cloud and Analytics
What the best patterns of scalable architecture are (Microservices, Event-driven Architecture, etc.) – will enable you to create a high-performance, reliable healthcare app that will scale with your end users.
Conclusion
To Build scalable healthcare applications requires thorough planning, strong architecture, secure services and continuous performance improvement from back-end technologies and features that engage users, scalability should be built into every layer of your development roadmap.
